“… on whether the case is histoid or not …”

Leprosy Mailing List – October 16^th, 2011 

Ref.:    “… on whether the case is histoid or not …”

From: K Al Aboud, Makkah, Saudi Arabia

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Dear Dr Noto,

Greetings, I would like to thank you for your continuous efforts in maintaining the LML as an important resource for health care providers interested in leprosy.  I want also, to thank , Dr P. Narasimha Rao, for his posting.  However, I want to comment about the importance of identifying the cases of histoid leprosy.

This unique type of leprosy has a peculiar clinical, pathological and therapeutic response.  It is well-known this type of leprosy is resistance to treatment.  A possible explanation for that, is decreased bioavailability of the anti-leprosy medications in the tissue.  The reason for this might be the conversion which occurs in the tissue from cellular (histiocytic) toward a more fibrous (spindle-like cells), in the histoid type and hence, the concentration of the drugs is less in the histoid type.  This plus others immunological, microbial , and host factors make this type difficult to treat.

The observations and future researches on this type will for sure increase our understanding to the pathogenesis of leprosy in general.  I may refer Dr Rao, and our colleagues in LML to 2 good reviews on this type of leprosy in the following papers:-

1. Mendiratta V, Jain A, Chander R, Khan A, Barara M. A nine-year clinico-epidemiological study of Histoid Hansen in India. J Infect Dev Ctries. 2011 Mar 2;5(2):128-31

2. Sehgal VN, Srivastava G, Singh N, Prasad PV. Histoid leprosy: the impact of the entity on the post-global leprosy elimination era. Int J Dermatol. 2009 Jun;48(6):603-10

With my best regards,

Yours sincerely,

Dr Khalid Al Aboud

Consultant Dermatologist

King Faisal Hospital ,

P.O Box 5440

Makkah21955

Saudi Arabia

Tel 0096625566411 ext 1110